ALMOST 4,000 patients were treated privately under the National Treatment Purchase Fund last year by the same consultant they had been assigned on the public waiting list.
Correspondence received by the Dáil's finance watchdog, the Public Accounts Committee, discloses that, in 2007, the total number of cases where a consultant treated a patient in a private hospital who had been on that consultant's waiting list in a public hospital was 3,802, or 11.6 per cent of cases treated.
Committee chairman Bernard Allen expressed serious concern about what he said was the high incidence of the practice. He said that in some cases consultants were getting paid twice - in both the public and private system - for treating the same patient.
"There is a major defect in the scheme. We are seeing consultants who are paid on the double from the public purse for treating the same patient. The situation is not acceptable," said Mr Allen.
The committee obtained the information from the purchase fund in a series of queries following its examination of the fund at a public sitting on May 29th.
In a letter to the committee dated June 10th, purchase fund chief executive Pat O'Byrne discloses that almost one in five consultants treated a patient in a private hospital who had originally been on their public waiting list.
Mr O'Byrne also supplies figures for the first four months of 2008. It shows that the corresponding figure for private treatment of patients by the same consultant under whose public care they were was 859, or 8.7 per cent to the end of April.
Mr Allen said he intended for the committee to discuss the matter again in light of the figures that it has received.
Other correspondence in 2007 shows that the number of patients treated under the purchase fund in public hospitals was 2,528, or 8 per cent of all cases. The fund says it is only permitted to purchase capacity from the public hospital system where it exists and where it does not adversely affect core activity.
Mr O'Byrne outlined the reasons for using the same consultant in a private capacity. He said while the purchase fund's policy is to use different consultants, there were cases where that was not possible.
In the June 10th letter, Mr O'Byrne states: "In order to facilitate acceptable and safe treatment for these patients, and so as not to exclude them from access to faster treatment via the purchase fund, in limited circumstances it is best to allow the same consultant to treat certain patients."
Such circumstances include: children (who comprise 14 per cent of those waiting more than three months); capacity issues in certain specialities; some specialised surgeries; cases where the consultant has already treated the patient; and elderly care.